Systemic treatments in Parthenium dermatitis: A systematic review and meta-analysis.

Parthenium dermatitis is the commonest form of plant dermatitis in India, caused by the plant Parthenium hysterophorus. Systemic immunosuppressives are commonly employed in its treatment. However, there is a relative lack of comparative head-to-head trials. This study was done to assess the relative efficacy and safety of systemic treatments in Parthenium dermatitis. We systematically reviewed all the published studies investigating the safety and efficacy of systemic treatments for Parthenium dermatitis in the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and clinical trial registries. Treatment benefit data were tabulated based on outcome measures of scoring systems. The quality of evidence for each outcome was assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria for meta-analysis. The pooled Standardized mean difference (SMD) for case series and comparative studies based on clinical severity score (CSS) for azathioprine was 4.007 (95% CI (Confidence interval): 3.141, 4.873) and 0.746 (95% CI: 0.139, 1.352), respectively. About 88.8% (95% CI: 76.8%, 100.8%, p = 0.076) of the patients had excellent or a good response to azathioprine. Our meta-analysis shows that azathioprine has the highest level of evidence in the treatment of Parthenium dermatitis.

Community Perspective of Male Involvement in Maternal Health Care in Uttarakhand, India: A Qualitative Study.

Background: Due to the significant role of male in decision making in India, they may decide if, when and where a woman may access antenatal, delivery and postnatal care; and whether or not to provide financial resources to travel to these services. Men's involvement in maternity care is recognized as a key strategy in improving maternal health and accelerating the reduction of maternal mortality. This study explores key components and challenges to male involvement in maternal health care (MHC). Methods: Focus group discussions (FGDs) were conducted with a purposive sample of the community key stakeholders from the field practice area of All India Institute of Medical Sciences, (AIIMS) Rishikesh from October 2020 to January 2021. Manual thematic analysis with a semantic approach was used for the data analysis. Themes were prioritized using Participatory rural appraisal (PRA) technique. Results: Twenty-three participants represented the heterogeneous group of key stakeholders. Stakeholders identified the need for improved awareness regarding MHC services among men. Husband involvement is affected by availability (work stations at different places), literacy, gender-based work domain and social cultures, finances and health facility environment.Four major themes were identified: Male involvement in antenatal, intranatal; postnatal care; and barriers to male involvement in MHC. Sub-themes under male involvement in antenatal care; intranatal care; and postnatal care were further prioritized via PRA as 'very important'; 'important' and 'not so important' and scores were given as 3, 2 and 1 respectively. Conclusions: Male involvement is a key strategy to improve pregnancy outcome; however, different challenges exist in their involvement in the maternal health care. Current study helped to contextualize the perception regarding importance of male involvement in MHC; and the situation of study area in order to understand social and cultural factors that shape the behavior and practices of men in relation to their involvement.

Psychological distress and well-being assessment among Indian people during COVID-19 pandemic.

Background: A rapid spread of the COVID-19 pandemic restricted millions of people in their homes and affected them with anxiety, stress, and psychological distress. This online study was conducted to assess the psychological distress among the Indian population. Method: This is a cross-sectional study, data collected via an online self-reported questionnaire using a snowball sampling technique. COVID-19 psychological stress was measured through the COVID-19 peritraumatic distress index (CPDI). This questionnaire was open-access and adapted from the Shanghai Mental Health Centre. Data were extracted to Microsoft Excel and analyzed in SPSS 23 version. Ordinal logistic regression was used to calculate the odds ratio for predicting variables. Results: A total of 625 responses were received. The mean age of the respondents was 26.41 years (standard deviation [SD] = 9.35; range = 17-79 years) with 320 (51.2%) males and the majority (68.8%) of the respondents were students. Youth with age group between 21 and 25 years were observed to be having peritraumatic distress 2.42 times more than the other groups (P = 0.001). Females were found to be more nervous and anxious (χ2 = 5.12; P = 0.02), more sluggish reaction due to anxiety (χ2 = 9.46; P = 0.002) as compared to males. Unmarried respondents were observed to be more sluggish due to anxiety (χ2 = 7.2; P = 0.007), felt more tired and exhausted (χ2 = 6.12; P = 0.013) in comparison to married. Conclusion: COVID-19 pandemic crisis significantly affected a major segment of society. The psychological distress level was observed to be high among youth, females, and a group of people in quarantine or isolation.

Capacity building of primary care physician working at remote Uttarakhand, India: An integrated tertiary care approach during COVID 19 pandemic.

Strengthening primary care during this unprecedented pandemic of COVID-19 is an urgent demand for public health. It needs to relook into the healthcare machinery and reenergize the much overlooked primary and secondary tier in healthcare delivery to effectively combat COVID-19 and other similar epidemics. OBJECTIVES: Strengthening of primary care and enhance the skills and knowledge of primary care physician working at Community Health Center/Primary Health Center (CHC/PHC) in context of Family medicine and updating them in recent advancements in primary care management and COVID 19 guidelines for efficient delivery of primary care services. METHODOLOGY: Director general health services of Uttarakhand was intimated with the aim and objectives of this one-day hands-on workshop going to be conducted at All India institute of medical sciences. All Chief Medical Officers of the various districts had been communicated and sensitized for this noble cause. Total 30 primary care physicians attended the certificate program. This session commenced with a pre-test followed by the lectures, discussions and hands-on skills and ended with a post-test. RESULTS: Majority (60%) of the participants were male and 40% were female. A total of 30% had never attended any similar workshop in the past. 45% of them were never exposed to any hands-on training before. Only 10% of them were Postgraduates and the rest were only MBBS (undergraduate). As the scores were not normally distributed, Wilcoxon Signed-Ranks Test was applied for the dependent variable. There was a significant difference (p < 0.05) found between pre and post-test results. CONCLUSION: Imparting continuing medical knowledge to the physicians has proved to be an effective tool in good clinical practice. The success of this intervention can be used to further develop and implement workshops and other training sessions to enhance the skills and knowledge of Primary Care Physicians in similar settings that face a shortage of well-equipped physicians.